Tech to transform health care

Amazon took a small but significant step earlier this month toward the goal of becoming as disruptive an innovator in the delivery of health care as it is in the sale of consumer products. Working together with several prominent health care organizations, which developed a series of tools for Amazon Alexa, the company has made its virtual digital assistant compliant with the patient privacy and security requirements of the Health Insurance Portability and Accountability Act. With millions of voice-activated, Alexa-enabled devices already in use in people’s homes, the availability of the new “skills” related to health care could represent a turning point in the technology-driven evolution of patient care.

Among the prominent organizations working to harness Alexa’s reach are health insurer Cigna and its Express Scripts pharmacy benefits management subsidiary. The “skill” developed by the latter is tailored to users of the PBM’s prescription home delivery service, a group that Express Scripts asserts can benefit from lower costs, a higher degree of convenience and privacy, and better adherence to medication regimens. By saying, “Alexa, open Express Scripts,” participants can now get an update on the status of their orders and request notifications about when orders are received, processed and shipped.

“With our new Express Scripts ‘skill,’ we’re trying to make it easier for people to make better-informed health care decisions,” says vice president of innovation and member experience Mark Bini. “In particular, we believe voice technology, like Alexa, can make it easy for people to stay on the right path by tracking the status of their mail-order prescriptions, helping us further solve the costly and unhealthy problem of medication nonadherence.”

If Alexa and other voice-activated systems catch on for prescription ordering, they could disrupt the way pharmacists have traditionally interacted with patients by reducing the occasions when they see each other. Another of the “skills” unveiled this month, a tool from Livongo Health Inc. that helps diabetes patients keep track of their blood glucose levels and provides information about how to control them, and similar remote monitoring systems could potentially lend support to community pharmacists in their quest to play a bigger part in assisting patients with the management of chronic conditions.

Whatever impact Alexa ultimately has on health care delivery, the launch of the HIPAA- compliant “skills,” coupled with Amazon’s purchase of online pharmacy PillPack in June 2018 and its joint venture to remake health care with Berkshire Hathaway and JPMorgan Chase, demonstrates the company’s intention to be a major force in the field and its belief that cutting-edge technology will help transform it.

Amazon is not alone in that conviction. A host of companies — newcomers as well as established players in both technology and health care — are intent on applying advanced information systems and digital devices to make health care more effective and less costly. Examples are easy to come by. Two important deals were announced during the week before this issue of MMR went to press.

McKesson, one of the nation’s three dominant pharmaceutical wholesalers, which also runs the Health Mart chain of 5,032 independent pharmacies, teamed up with Google Cloud to foster the development of advanced applications and other products, machine learning and artificial intelligence technologies, and enhanced analytics capabilities. The Google Cloud platform will be implemented throughout the McKesson enterprise.

“We’re excited to work with Google to design a cloud infrastructure that frees us up to solve for the future of health care,” says Andy Zitney, senior vice president and chief technology officer of McKesson Technology. “We are accelerating our migration and development process, which means we will be able to deploy new products and features for our customers faster, decreasing our time to value.”

Google Cloud was a participant in another notable partnership, joining forces with consulting firm Deloitte to craft transformational solutions for the health care, retail and financial industries. Efforts in the first sector will focus on enhancing access to care, improving data management, optimizing operations and accelerating the pace of biomedical research and development. (The retail work will center on consumer insights and engagement, connected supply chains and reducing costs by updating infrastructure.)

“Many share a need to modernize — quickly,” notes Thomas Kurian, chief executive officer of Google Cloud. “We’re excited to join with Deloitte to deliver solutions and technology to help them do just that.”

Kurian’s view is shared by most major health care providers, who, along with the people they serve, are troubled by the higher costs and poorer patient outcomes in the U.S. than those in other industrialized nations. They rightly see digital technology, artificial intelligence, machine learning and robotics as a catalyst for fixing a broken system. Companies that fail to embrace those tools are likely to find that standards in health care and the patient expectations that go with them have left them ­behind.